Factors associated with afebrile presentation and delayed defervescence of bacterial meningitis in children under 3 years of age: a multi-centre retrospective analysis.

BACKGROUND: This multi-center study aimed to identify factors affecting fever and delayed defervescence in bacterial meningitis (BM) patients under 3 years of age because of the variability of fever in this patient population. METHODS: Only BM patients under 3 years treated at 49 centers in China from November 2018 to end-April 2021 were included in the study. Univariate and multivariate logistic regression analyses were performed to determine factors associated with afebrile presentation and fever of delayed defervescence. RESULTS: A total of 863 BM patients under 3 years were included in the study. Coagulase negative staphylococcus was associated with afebrile presentation (OR = 1.176), while septicaemia and ear-nose-throat infections were associated with fever (P < 0.05). The patients with fever were assigned into early and delayed defervescence groups based on defervescence time (less than and more than or equal to one week). Furthermore, Streptococcus agalactiae meningitis (OR = 1.124), concomitant gastrointestinal infection (OR = 1.276), encephalomalacia (or = 1.339), and subdural effusion (OR = 1.454) were independently associated with delayed defervescence (all P < 0.05). CONCLUSIONS: The findings can aid in the efficient utilization of fever in auxiliary diagnosis and evaluating the condition of the disease.

Study of surface activation markers on CD3- CD16+ NK cells and their correlation with clinical manifestations in children with infectious mononucleosis.

This study aimed to investigate the proportion of surface activation markers on natural killer (NK) cells in children with infectious mononucleosis (IM) and to explore its clinical relevance. A total of 17 children hospitalized with IM were included in this study as the experimental group. Meanwhile, healthy children matched for age and gender served as controls. First, we isolated peripheral blood mononuclear cells from children with IM and healthy children. Then, NK cell surface markers were stained with monoclonal antibodies and analyzed by flow cytometry. The results showed that the percentage of CD3- CD16+ NK cells was higher in peripheral blood lymphocytes from children with IM than that from healthy children (t = -4.52, P < 0.05). And the expression of the surface activation markers CD69 and CD25 on CD3- CD16+ NK cells was also higher in children with IM (t = -7.729, P < 0.05; t = -5.068, P < 0.05). There was a positive correlation between the percentage of CD3- CD16+ NK cells in peripheral blood and the duration of fever in children with IM (r = 0.530, P < 0.05). Therefore, the proportion of NK cell subsets in children's peripheral blood changes in the acute phase of IM, suggesting that NK cells enhance their cytotoxicity and play a role in the control of infection in children with IM. Higher levels of CD3- CD16+ NK cells and the association with disease progression suggest that these cells might be a useful index to help evaluate the disease course.